Immersive virtual reality helps patients with depression

Virtual reality therapy could help treat depression by encouraging people to be easier on themselves and improve their chances of breaking the cycle of depression, says a new study published in the British Journal of Psychiatry Open.

A virtual reality scenario could help patients to feel better about themselves.

In 2014, 6.6% of American adults experienced at least one bout of major depression.

The National Institute of Mental Health (NIMH) defines depression as a "period of 2 weeks or longer during which there is either depressed mood or loss of interest or pleasure and at least four other symptoms that reflect a change in functioning, such as problems with sleep, eating, energy, concentration and self-image."

Self-criticism is common among people with depression. Increasing levels of self-compassion appears to help, but some patients find it hard to show compassion toward themselves.

A negative self-image can increase an individual's sense of vulnerability and contribute to the persistence of the depression.

Embodiment in an avatar

A team, led by Prof. Chris Brewin of University College London (UCL) Clinical, Educational and Health Psychology department, tried the technique first with healthy volunteers.

The researchers then invited 15 patients with depression to try it. They were aged 23-61 years, 10 were men, and five were women. Ten of the patients were taking antidepressants, seven were receiving psychological therapy, seven were waiting for therapy and one had completed a course of therapy.

Each session lasted about 8 minutes, and it was repeated once a week for 3 weeks.

The process involved a technique known as "embodiment," in which participants wear a virtual reality headset to enable them to see from the perspective of a life-size "avatar," or virtual body.

As they watched in a mirror, the virtual body moved in the same way as their own body, giving the illusion that it was their body.

While embodied in the avatar, participants learned to show compassion toward a distressed virtual child. As they interacted with the child, the figure gradually stopped "crying" and responded positively to the compassion.

A few minutes later, the patients were embodied in the virtual child. As the child, they experienced the adult avatar delivering the compassionate words and gestures that they had used previously.

Self-compassion replaces self-criticism

When patients were followed up a month later, the results were positive.

Nine of the patients reported that their depressive symptoms and level of self-criticism had reduced. For four of these, the reduction was clinically significant. Participants reported feeling more self-compassion. Perceptions of the scenario were positive, and repeating the sessions helped to deepen some aspects of the experience.

Several patients also reported that they were less self-critical in real-life situations, too, following the activity.

As a result, the researchers conclude that immersive virtual reality could be useful as an intervention for patients with depressive symptoms.

Prof. Brewin explains:

"People who struggle with anxiety and depression can be excessively self-critical when things go wrong in their lives. In this study, by comforting the child and then hearing their own words back, patients are indirectly giving themselves compassion. The aim was to teach patients to be more compassionate towards themselves and less self-critical, and we saw promising results."

The study, which involved researchers from UCL and ICREA-University of Barcelona, looks promising, but the researchers say that the trial so far is too small to prove conclusively that the therapy will be useful. They now hope to develop the technique further and carry out a larger trial to establish the benefits.

Co-author Prof. Mel Slater, of ICREA-University of Barcelona and UCL Computer Science, sees great potential if substantial benefit can be demonstrated.

As low-cost virtual reality systems for domestic use have become more widely available in recent years, he believes such therapies could be viable, even for use at home.

Recommended related news

Embodying self-compassion within virtual reality and its effects on patients with depression, Caroline J. Falconer, British Journal of Psychiatry Open, doi: 10.1192/bjpo.bp.115.002147, published 15 February 2016.

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